Sándor Ferenczi: From Clinical Turmoil to Theoretical Articulations

The article deals with concepts proposed by Sándor Ferenczi: confusion of tongues, disavowal and progressive trauma, illustrated by a clinical example, in which excessive life experiences deeply determined the psychic construction, compromising the integrity of the self-image and the potentiality of egoic capacities. We attempt to understand the uniqueness of the patient's history, and the ethical practice of deep analytic listening.     

No More Away: Techno-Attachments and the Relational Future

This paper speculates about the impact of techno-connectedness on our children, ourselves, our grandchildren. Triggered by recollections from Victorian novels that describe European summers “away” from home, a concern about loss of opportunity, the “space” for self-discovery in this young generation will be explored in a relational context. Brought about by pervasive dependence upon computer technology, is self-experience fragmented and attachment changed by the ubiquitous technological presence and is the more isolated, reflective experience being eroded?     

Psychosis: A Synthesis of Motivational and Defect Perspectives

Based on the evolution of human intelligence and the tremendous cognitive capacities arising from it, we have an innate tendency for the extreme thought content, thought form, and sensory perceptions of psychosis. During the conscious and awake state, cognitive regulatory control processes block these more extreme variants to facilitate reality congruency necessary for adaptive functioning. While asleep there is no need for reality congruency and the cognitive regulatory control processes are deactivated allowing psychotic equivalents to be expressed in dreams. This paper helps synthesize the two dominant perspectives regarding the etiology of psychosis: the neuroscience defect perspective and the psychoanalytic motivational perspective. Regarding the former, defective cognitive regulation arising from certain conditions, such as the deficit state of schizophrenia, allows extreme cognitive distortions, thought form variants, and sensory perceptual experiences to intrude into the conscious and awake state, thereby producing psychosis. Consistent with the psychoanalytic motivational perspective, defensive processes can motivate extreme cognitive distortions, thought form variants and sensory perceptual experiences, and also facilitate their expression by deactivating the relevant cognitive regulatory control processes.     

Critical Transference in a Case of Severe Epilepsy

In this paper, the author presents a summary of a brief treatment with a young woman, suffering from severe epileptic illness, which describes the mutuality of cross-transferences of deep and intense feelings and the unorthodox way to receive, to take in persons affected with critical phenomena. This treatment was deeply influenced by the traumatic triad, borrowed from Ferenczi: "amnesia, anaesthesia, aboulia," the ways of forgetting (or erasing) the past/the present/the future. The investigation led us to clarify, on the one hand, the incestophilic-or perhaps incestuous-source in the family, and on the other, the burdensome and tragic genealogy and history of each parent. At the end of this short treatment, which took place at a frequency of one session a week (with the patient sitting, standing, lying on the floor; with sometimes severe fits, deliria, threats; bringing of letters, texts, drawings; and a few phone calls), there was an alleviation of the critical phenomena and revival.     

The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders

The present study aimed to understand the contributions of both the trait tendency to experience negative emotions and how one relates to such experience in predicting symptom change during participation in the Unified Protocol (UP), a transdiagnostic treatment for emotional disorders. Data were derived from a randomized controlled trial comparing the UP to a waitlist control/delayed-treatment condition. First, effect sizes of pre- to post-treatment change for frequency of negative emotions and several variables measuring reactivity to emotional experience (emotional awareness and acceptance, fear of emotions, and anxiety sensitivity) were examined. Second, the relative contributions of change in negative emotions and emotional reactivity in predicting symptom (clinician-rated anxiety, depression, and severity of principal diagnosis) reductions were investigated. Results suggested that decreases in the frequency of negative emotions and reactivity to emotions following participation in the UP were both large in magnitude. Further, two emotional reactivity variables (fear of emotions and anxiety sensitivity) remained significantly related to symptom outcomes when controlling for negative emotions, and accounted for significant incremental variance in their prediction. These findings lend support to the notion that psychological health depends less on the frequency of negative emotions and more on how one relates to these emotions when they occur.     

Empathy Deficit in Antisocial Personality Disorder: A Psychodynamic Formulation

Empathic difficulty is a highly consequential characteristic of antisocial personality structure. The origin, maintenance, and possible resolution of this profound deficit are not very clear. While reconstructing empathic ability is of primary importance in the treatment of antisocial personality, not many proven procedures are in evidence. In this article, the author offers a psychodynamic formulation of the origin, character, and maintenance of the empathic deficiency in antisocial personality. The author discusses some of the treatment implications from this dynamic formulation.     

How Does Neurobiological Research Influence Psychoanalytic Treatments?—Clinical Observations and Reflections From a Study on the Interface of Clinical Psychoanalysis and Neuroscience

One of the counterarguments against empirical research in psychoanalysis is that research negatively influences the treatment situation. In this paper, the impact of a neurobiological study on psychoanalytically oriented treatments is presented from three different perspectives: patients' views, a study group of participating psychoanalysts and a clinical case example. Twenty chronically depressed patients, 20 healthy controls and 16 psychoanalysts participated in the project on research. Results show a clear influence of the neurobiological study on the course of treatments. Patients consistently reported that study participation had a positive impact on their treatment experiences. However, study participation was conflictual for the psychoanalysts and forced them to carefully reflect on their unconscious and conscious involvement to establish a psychoanalytic stance independent from empirical research.